Northwell Health deploys Microsoft Teams as secure messaging tool for clinical staff

The hospital network has also reduced time interacting with EMR systems thanks to a chatbot built on the collaboration platform.

Virtual security technology focuses on the Microsoft Teams logo as someone uses her mobile phone.
Thinkstock / Xresch / Microsoft

Northwell Health is connecting tens of thousands of hospital workers with Microsoft Teams, improving collaboration between clinical staff and reducing the time needed to access patient information.

Northwell, the largest hospital network in the New York City area with 23 hospitals and 800 outpatient facilities, began its deployment of Teams as a secure messaging platform at the start of last year.

The reason for choosing Teams was to provide staff with a secure and compliant method of text communication, enabling hospital workers to share protected health information (PHI) on mobile devices, said Northwell Health’s chief medical information officer, Michael Oppenheim.

“At the most basic level, we need to provide a solution to enable providers to be able to communicate in a HIPAA-compliant way,” said Oppenheim. “Standard SMS texting on a phone is not sufficiently secure, so we wanted to be able to provide folks with something they could use from a desk, from a handheld [device], and have ad hoc communications with each other.”

Video is another key use case for connecting clinical staff. “Right from within Teams you can communicate, you can launch a meeting, you can have a multi-way collaboration with video. It enables us to take what we wanted from a clinical collaboration perspective beyond just an ad hoc texting tool.”

Team collaboration at Northwell

The rollout to clinical staff is complete at two hospitals, Cohen Children’s Medical Center (CCMC) and Glen Cove, while leaders at other hospitals are also using Teams. More than 20,000 staff employees are currently using the application on a regular basis. It will eventually be made available to all 63,000 of Northwell’s employees who are licensed on Office 365.

Teams is Microsoft’s workplace collaboration app, launched in 2017 and available for free with certain Office 365 subscriptions. It combines team chat, videoconferencing and document editing capabilities and is deeply integrated with other Office 365 apps and services.

As part of its push to compete with rival Slack, Microsoft has developed a raft of additional features to address industries such as healthcare. This includes functionality such as the ability to annotate and send patient images securely and integration with electronic medical record (EMR) platforms.

There are clear benefits to using an enterprise-grade platform for collaboration and communication, said Larry Cannell, a research director at Gartner. “In the past, using an enterprise product meant that users had to compromise on ease of use and design. This is no longer the case with solutions like Teams or Slack,” said Cannell.

“From an IT perspective, this messaging integrates with their corporate directory, data-loss prevention and data retention/compliance systems already in place. Users can feel more confident that messages will not accidentally leak and can more easily find their colleagues.”

Although Northwell considered other enterprise messaging solutions, the provider typically found them to be more limited in scope, said Oppenheim. Teams is also better suited for communicating with multiple co-workers, sharing images and even collaborating around documents in OneDrive, Oppenheim added.

“We really wanted to create a foundational platform that enabled clinicians to collaborate, not just one-on-one but in groups, and work in ways that are far more valuable than just simply the ability to communicate with each other,” said Oppenheim. 

This means the ability to “pull multiple clinicians into a chat conversation, or schedule a meeting and have an ad hoc video chat among three or four clinicians that need to work on a patient,” for example. 

“As we build more integration into our electronic records and scheduling, the types of collaboration that we expect to see in this platform are going to grow,” he said.  

Clinical staff are using a range of Android and iOS mobile devices, though Glen Cove and CCMC are predominantly using Samsung J7 smartphones. Previously, staff at Northwell communicated via pagers and IP-based phones, which will be phased out as a result of the Teams deployment.

Teams chatbot: ‘The first piece of medical IT that has saved me time’

The healthcare provider has also built a chatbot on top of Teams to provide electronic EMR information to clinicians on mobile devices using natural-language commands.

The chatbot, dubbed NORA, is used to provide clinicians with access to patient data directly from their mobile device. 
There are around 100 clinicians currently using NORA. “It allows them to get at EMR data very flexibly when they are on the move and interacting with patients or colleagues,” said Oppenheim.

“It’s the first piece of medical IT that has saved me time,” said Dr. Mark Atlas, chief of the Childhood Brain and Spinal Cord Tumor program at Cohen Children’s Medical Center.

“We all know that electronic medical records increase the amount of time that physicians spend with their note writing and everything else. This is the first thing that actually decreases time.” 

It means reducing time spent accessing patient information from minutes to just a few seconds, he said. “It takes about ten to fifteen seconds for each entry to produce a result,” said Dr. Atlas.

“Compare that with having to go out of a room, log on to a computer, wait for that to load up, then log in to the particular application that I want to use and get everything, which takes roughly four to five minutes. 

“It allows me to pull up radiology, pathology, pretty much any result that I want. It also allows me to pull up notes, so if I'm waiting for a consultant's report, I can do that.” 

It’s also possible to set alerts, notifying clinicians on their mobile device when lab results arrive. “I know immediately ‘yes’ or ‘no,’” said Dr. Atlas.

Use of the bot also enables clinical staff to provide a better service to patients. “It saves time, but it is also increasing our ability to give patients and families information in a timely fashion,” said Dr. Atlas.

And there is more to come with the NORA bot, he said. This includes the ability to view data related to patient vital signs and medication.

“We are going to be able to have our vital signs available on the bot. Not long after that, the plan is to be able to access different medications on the bot, and the last time they were dosed. This is all stuff that we'll be able to get in 10 to 20 seconds rather than several minutes,” Dr. Atlas said.

Plans for wider deployment

Encouraging staff to use a new digital tool can often be a challenge for large organizations, but adoption of Teams at Northwell has been relatively painless so far, according to Oppenheim and Dr. Atlas, while clinicians have been positive about interactions with the chatbot.

“We really haven't had a tremendous amount of resistance,” said Oppenheim. “Uptake is not always the quickest, but once you get to a critical mass in a facility, then all the orbiting people around those practitioners start to get on board.”

Following the success of the pilot deployment to date, Northwell Health plans to deploy Teams more widely across its organization at a rate of one hospital every other month, with a proposed completion date of the end of 2021.

“As Teams rolls out we expect that [the chatbot] can roll out pretty fast behind it,” said Oppenheim.

Copyright © 2020 IDG Communications, Inc.

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